Hypertensive emergencies and urgencies need prompt diagnosis and management because they may potentiate organ dysfunction and even lead to death if not appropriately treated (1-8). The goal of initial treatment in these patients is to obtain a safe and controlled reduction in blood pressure (BP) to a more physiologic, noncritical level, but not necessarily to a normotensive state. The initial examination should include careful fundoscopic, mental status, and cardiovascular evaluation. A true hypertensive emergency (e.g., malignant hypertension) is usually defined in the setting of a diastolic BP (DBP) >130 mmHg. This is especially true if it is accompanied by altered mental status papilledema, myocardial infarction (MI), pulmonary edema, evolving stroke, or a dissecting aneurysm (Table 40-1).
KeywordsMean Arterial Pressure Sodium Nitroprusside Severe Hypertension Acute Aortic Dissection Malignant Hypertension
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